Lynn Patricio B, Cronin Catherine, Rangarajan Sriram, Widmar Maria
Division of Colorectal Surgery, Department of General Surgery, New York Presbyterian - Weill-Cornell, New York, New York.
Colorectal Surgery Service, Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Clin Colon Rectal Surg. 2023 Feb 22;37(1):30-36. doi: 10.1055/s-0043-1762561. eCollection 2024 Jan.
Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer. When IBD patients develop a rectal cancer, this should be treated with the same oncological principles and guidelines as the general population. Rectal cancer treatment includes surgery, chemotherapy, and radiation therapy (RT). Many IBD patients will require a total proctocolectomy with an ileal-pouch anal anastomosis (IPAA) and others, restoration of intestinal continuity may not be feasible or advisable. The literature is scarce regarding outcomes of IPAA after RT. In the present review, we will summarize the evidence regarding RT toxicity in IBD patients and review surgical strategies and outcomes of IPAA after RT.
炎症性肠病(IBD)与结直肠癌风险增加相关。当IBD患者发生直肠癌时,应按照与普通人群相同的肿瘤学原则和指南进行治疗。直肠癌治疗包括手术、化疗和放射治疗(RT)。许多IBD患者需要进行全直肠结肠切除术并回肠储袋肛管吻合术(IPAA),而对其他患者来说,恢复肠道连续性可能不可行或不可取。关于RT后IPAA的结果,文献报道较少。在本综述中,我们将总结关于IBD患者RT毒性的证据,并回顾RT后IPAA的手术策略和结果。